Caffeine and Glucose Regulation

根据美国糖尿病协会的数据，超过2000万美国人患有糖尿病， 2002年的年经济损失为1320亿美元。努力管理糖尿病及其许多严重 并发症的重点是控制葡萄糖水平和预防高血糖症， 疾病我们在这个项目中的研究发现，咖啡因，这种药物存在于许多流行的 2型糖尿病是由糖尿病患者的饮食、饮食和药物引起的。 具体来说，咖啡因会夸大餐后（餐后）葡萄糖和胰岛素的增加 高血糖症和高胰岛素血症），并提高白天血糖 在正常日常生活活动中测量的水平。我们提出了两项新的研究，以推进我们的 了解这些咖啡因在糖尿病管理中的临床重要性。 尽管我们已经证明咖啡因会严重干扰餐后葡萄糖的代谢， 从饮食中消除咖啡因将改善2型糖尿病患者的血糖控制， 习惯性地服用药物。我们将通过一项随机对照的实验研究来回答这个问题。一 2-为期一周的密集调查将测试咖啡因戒断对降低血糖的短期疗效 水平和餐后反应。持续随访3个月将提供以下初步证据： 治疗效果。这项研究将结合联合收割机短期和长期的血糖控制生化措施 在日常生活活动中进行葡萄糖的动态测量。我们还将比较各组的重 和轻消费者测试一个“剂量反应”假设，即那些谁消耗更多的咖啡因将获得 更大的好处从戒烟。本研究的结果将证明 从饮食中消除咖啡因，这将指导后续的大型临床试验。 咖啡因如何损害葡萄糖代谢也是未知的，来自健康年轻男性的证据表明， 咖啡因的作用可能是通过肾上腺素的释放来介导的。我们将在2型糖尿病患者中检验这一假设。 糖尿病一项对照实验室研究将测试药理学β-肾上腺素能阻滞剂是否能减弱 或消除咖啡因对餐后葡萄糖和胰岛素的影响。建立这个看似合理的 咖啡因作用的生理机制将加强咖啡因与 和2型糖尿病的血糖控制受损。 咖啡因是世界上使用最广泛的药物，尽管有证据表明其影响可能对健康有害。 拟议的研究将促进我们对咖啡因摄入对葡萄糖的临床影响的理解 2型糖尿病的治疗结果可能会导致有关咖啡因消费的建议， 可以改善数百万患有这种疾病的患者的临床结果并减少并发症。

According to the American Diabetes Association, more than 20 million Americans have diabetes, with a total annual economic cost in the year 2002 of $132 billion dollars. Efforts to manage diabetes and its many serious complications focus on control of glucose levels and prevention of the hyperglycemia that characterizes the disease. Our research in this project has found evidence that caffeine, the drug present in many popular beverages, foods, and medications, contributes to the unhealthy hyperglycemia of type 2 diabetes. Specifically, caffeine exaggerates the glucose and insulin increases that follow a meal (postprandial hyperglycemia and hyperinsulinemia) in men and women with type 2 diabetes and raises daytime glucose levels measured during the activities of normal daily life. We propose two new studies to advance our understanding of the clinical importance of these caffeine effects in the management of diabetes. Although we have shown that caffeine acutely disrupts postprandial glucose disposal, we do not yet know that eliminating caffeine from the diet will improve glycemic control in those patients with type 2 diabetes who habitually consume the drug. We will answer this question with a randomized controlled experimental study. A 2-week intensive investigation will test the short-term efficacy of caffeine abstinence for reduction of glucose levels and postprandial responses. Continued follow-up for 3 months will provide preliminary evidence of treatment effectiveness. This study will combine short and long-term biochemical measures of glucose control with ambulatory measures of glucose during the activities of daily life. We will also compare groups of heavy and light consumers to test a ¿dose-response¿ hypothesis, that those who consume more caffeine will receive greater benefit from quitting the drug. Results from this study will demonstrate the potential clinical benefits of eliminating caffeine from the diet that will guide the larger clinical trials to follow. How caffeine impairs glucose metabolism is also unknown Evidence from healthy young men suggests that caffeine¿s effects may be mediated by epinephrine release. We will test this hypothesis in patients with type 2 diabetes. A controlled laboratory study will test whether pharmacological beta-adrenergic blockade attenuates or eliminates the effects of caffeine on postprandial glucose and insulin. Establishing this plausible physiological mechanism for caffeine¿s actions will strengthen arguments for a causal link between caffeine and impaired glucose control in type 2 diabetes. Caffeine is the world¿s most widely used drug, despite evidence that its effects can be detrimental to health. Proposed studies will advance our understanding of the clinical impact of caffeine consumption on glucose management in type 2 diabetes. Results could lead to recommendations about caffeine consumption that could improve clinical outcomes and reduce complications in the millions of patients with this disease.